POLYARTERITIS NODOSA

General Information

DEFINITION--A disorder of connective tissue that is one of several related diseases of collagen tissue. Collagen is a protein molecule that forms the major part of all connective tissue. Polyarteritis causes inflammation of small and medium arteries, decreasing the blood supply to tissues supplied by the affected blood vessels. It is not contagious. The course may be acute, with fever, weight loss and rapid deterioration. If the course is chronic, body tissues will waste away over several years.

BODY PARTS INVOLVED--All body parts.

SEX OR AGE MOST AFFECTED

• Both sexes, but more common in men.
• All ages, but most common in adults under age 50.

SIGNS & SYMPTOMS--

Varies, depending on which organ is affected by the decreased blood supply. The most common include:

• Chest pain (heart involvement).
• Shortness of breath (lung involvement).
• Abdominal pain (intestinal and liver involvement).
• Blood in the urine (kidney involvement).
• Numbness and tingling of the hands and feet (nerve involvement).

CAUSES--

This is considered a disease of autoimmunity or hypersensitivity, although the cause is uncertain. In many persons, no predisposing factors can be found. Following are the most common preceding factors:

• Bacterial infections.
• Viral infections.
• Use of certain drugs, including sulfa drugs, penicillin, antithyroid drugs, gold and thiazide diuretics.
• Vaccines.
• HIV (AIDS).

RISK INCREASES WITH

• Family history of collagen or hypersensitivity disease.
• Smoking.

HOW TO PREVENT--No specific preventive measures.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory studies of kidneys and blood, including sedimentation rate (See Glossary).
• Angiography (See Glossary).

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Hospitalization for intensive treatment (severe cases).
• Surgery to remove part of the intestines, if they are involved.

POSSIBLE COMPLICATIONS--Kidney failure and death, despite treatment.

PROBABLE OUTCOME--This condition is currently considered incurable. However, symptoms may be relieved or controlled. With treatment, over 50% of patients survive 5 years or more. Without treatment, few patients live beyond 5 years. Scientific research into causes and treatment continues, so there is hope for increasingly effective treatment and cure.

How To Treat

GENERAL MEASURES--

• Learn about side-effects for any medicines prescribed for you.
• You have a high risk for infections, so avoid crowds when possible and stay away from individuals with a known infection.
• See arthritis in Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Cortisone drugs in high doses until acute symptoms diminish. Then symptoms may be controlled by alternate day cortisone.
• Drugs to treat disorders of organs involved with this serious disease, such as heart medications for heart involvement or antihypertensives for high blood pressure.
• Immunosuppressive drugs--either alone or with steroids--if other drugs fail. These drugs pose additional risks, including severe generalized septic bacterial infections.

ACTIVITY--Resume your normal activities gradually as symptoms improve.

DIET--Low-salt diet if you have high blood pressure (see Low-Salt Diet in Appendix).

Call Your Doctor If

• You have symptoms of polyarteritis.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.